The Association Between Caustic Ingestion and Psychiatric Comorbidity Based on 396 Adults Within 20 Years

Figures & data

Figure 1 Enrollment diagram for the study population (n=396) and control group (n=377).

Table 1 Characteristics of Caustic Ingestion Patients

Variables	Psychiatric Comorbidity		p value
	Present (n=396)	Absent (n=377)
Baseline status
Old (>65 years old)	98 (24.7)	59 (15.6)	0.002**
Female	238 (60.1)	153 (40.6)	<0.001***
Suicidal ingestions	370 (93.7)	205 (54.8)	<0.001***
Previous suicide attempts	58 (14.7)	6 (1.6)	<0.001***
Alcohol use disorder	84 (21.2)	56 (14.9)	0.022*
Illicit drug abuse	17 (4.3)	3 (0.8)	0.002**
Caustic ingestion
Caustic substances			0.368
Acidity	232 (58.6)	219 (58.1)
Alkalinity	135 (34.1)	122 (32.4)
Neutral	4 (1.0)	10 (2.7)
Unknown	25 (6.3)	26 (6.9)
Strong caustics (pH <2 or >12)	226 (60.3)	209 (59.9)	0.917
Ingestion amount, mL	100 (200)	50 (70)	<0.001***
Urgent EGD survey	385 (98.0)	373 (99.5)	0.108
Grade ≥2b	190 (58.5)	179 (52.0)	0.095
Grade ≥3a	155 (47.7)	127 (36.9)	0.005**
ETT + MV during EGD	47 (14.5)	29 (8.4)	0.014*
Incomplete study	40 (12.3)	24 (7.0)	0.019*

Notes: Data are presented as number (%) or median (IQR). The calculation of percentage excluded patients with missing values from chart review. The standards for asterisks are as follows: p<0.05*, p<0.01**, and p<0.001***.

Abbreviations: EGD, esophagogastroduodenoscopy; ETT + MV, endotracheal tube with mechanical ventilation; IQR, interquartile range.

Table 2 Impacts of Psychiatric Comorbidities on Caustic Ingestion Patients

Variables	Psychiatric Comorbidity		p value
	Present (n=396)	Absent (n=377)
Clinical courses
Admission	294 (74.8)	211 (56.7)	<0.001***
Hospital stay, days	10 (17)	5 (9)	<0.001***
In-hospital mortality	20 (6.8)	13 (6.2)	0.774
ICU admittance	84 (21.7)	37 (10.4)	<0.001***
ICU stay, days	8 (8.5)	6 (9)	0.345
Surgical intervention	85 (21.5)	50 (13.3)	0.003**
Emergent surgery	27 (6.9)	11 (2.9)	0.012*
Endoscopic dilatation	54 (13.7)	34 (9.0)	0.043*
Systemic complications	131 (33.3)	90 (24.3)	0.006**
Aspiration injury	82 (20.9)	51 (13.8)	0.010**
Respiratory failure	65 (16.5)	31 (8.4)	0.001**
Hepatic injury	30 (7.6)	20 (5.4)	0.214
Renal injury	40 (10.2)	23 (6.2)	0.047*
DIC	12 (3.1)	8 (2.2)	0.441
GI complications	147 (37.1)	105 (27.9)	0.006**
Stricture	92 (23.2)	64 (17.0)	0.030*
Bleeding	64 (16.3)	53 (14.3)	0.453
Perforation	21 (5.3)	10 (2.7)	0.065
Overall survival
3 months	264 (90.7)	213 (92.6)	0.442
6 months	249 (88.6)	194 (91.9)	0.222
1 year	217 (86.1)	171 (90.0)	0.216
3 years	153 (80.1)	138 (86.8)	0.096
5 years	118 (74.2)	114 (83.8)	0.045*
10 years	50 (53.2)	65 (73.0)	0.005**

Notes: Data are presented as number (%) or median (IQR). The calculation of percentage excluded patients with missing values from chart review. The standards for asterisks are as follows: p<0.05*, p<0.01**, and p<0.001***.

Abbreviations: GI, gastrointestinal; ICU, intensive care unit; IQR, interquartile range.

Figure 2 Urgent EGD grading for patients with each specific PC.

Notes: The standards for asterisks are as follows: p<0.05* and p<0.01**.

Abbreviations: ASD/AjD, acute stress disorder or adjustment disorder; BDs, bipolar disorders; DDs, depressive disorders; EGD, esophagogastroduodenoscopy; GAD, generalized anxiety disorder; PC(s), psychiatric comorbidities; SSDs, schizophrenia spectrum disorders.

Figure 3 Overall survival analyses with the Kaplan–Meier method. (A) ETT + MV during EGD (p<0.001); (B) Age (p=0.002); (C) GI complication (p<0.001).

Abbreviations: EGD, esophagogastroduodenoscopy; ETT + MV, endotracheal tube with mechanical ventilation; GI, gastrointestinal.

Table 3 Multivariate Cox Proportional Hazards Models of Overall Survival in Patients with PCs

Covariates	Case Number	HR for Death (95% CI)	p value^a
Model 1: patients with PCs (n=325)
ETT + MV during EGD			<0.001***
No requirement	278	reference
Required	47	6.38 (2.99–13.60)
Age			0.007**
<65	247	reference
≥65	78	2.80 (1.33–5.91)
GI complications			0.036*
Absent	222	reference
Complicated	103	2.30 (1.05–5.02)
Model 2: comparison with control group (n=615)
Ingested amount (unit: 100 mL)	615	1.14 (1.05–1.24)	0.003**
Psychiatric comorbidities			0.376
Absent	316	reference
Present	299	1.28 (0.74–2.23)

Notes: ^aThe p values were determined using Cox proportional hazards model. The standards for asterisks are as follows: p<0.05*, p<0.01**, and p<0.001***.

Abbreviations: CI, confidence interval; EGD, esophagogastroduodenoscopy; ETT + MV, endotracheal tube with mechanical ventilation; GI, gastrointestinal; HR, hazard ratio.